![]() A thin telescope-like instrument (a laparoscope) is pushed through the skin to look inside. This is a small operation which involves making a small cut, under anaesthetic, in the tummy (abdominal) wall below the tummy button (umbilicus). The only definitive way to confirm endometriosis is with a laparoscopy. The cysts can fill with dark blood and are known as 'chocolate cysts'. Large patches of endometriosis may form into cysts which bleed each month when you have a period. For example, the bladder or bowel may 'stick' to the uterus. Patches of endometriosis tend to be 'sticky' and may join organs to each other. They get there by spilling backwards along the Fallopian tubes when you have a period. ![]() One theory is that some cells from the endometrium get outside the uterus into the pelvic area. The lining of the womb (uterus) is called the endometrium. There have been several theories for the cause of endometriosis over the years. This can cause unusual pains in parts of the body that occur at the same time as period pains. Very rarely, patches of endometriosis occur in other sites of the body.Other symptoms include fatigue, pain on passing poo (faeces), pain in the lower abdomen when you pass urine, low back pain and, rarely, blood in the urine or faeces.Sometimes, the reason for reduced fertility is not clear. This may be due to clumps of endometriosis blocking the passage of the egg from an ovary to the Fallopian tube. Difficulty becoming pregnant ( reduced fertility).Other menstrual symptoms may occur - for example, bleeding in between periods.Sometimes the pain is constant but it is usually worse on the days just before and during a period. Pain in the lower tummy (abdomen) and pelvic area.The pain is typically felt deep inside and may last a few hours after sex. It is different to normal period pain which is usually not as severe and doesn't last as long. The pain typically begins a few days before the period and usually lasts the whole of the period. More common endometriosis symptoms include: There are many different possible symptoms. Some women have just a few spots of endometriosis but have bad symptoms. Some women have large patches of endometriosis with no symptoms. In general, the bigger the patches of endometriosis, the worse the symptoms. If symptoms develop they can vary, and include those listed below. Many women with endometriosis have no symptoms. Patches of endometriosis can vary in size from the size of a pinhead to large clumps. ![]() See the seperate feature Living with endometriosis - Keisha's story. This protective effect may persist for up to a year after stopping 'the pill'. The combined oral contraceptive pill (often called 'the pill') reduces the risk of developing endometriosis.Oestrogen levels fall after the menopause. Endometriosis is rare in women past the menopause, as to develop endometriosis you need oestrogen, the female hormone.Therefore, endometriosis is more common in close blood relatives of affected women. Sometimes endometriosis symptoms begin in the teenage years. If endometriosis symptoms develop they typically begin between the ages of 25-40. Estimates vary, so that from about 1 in 10 to as many as 5 in 10 of all women develop some degree of endometriosis. Investigations to diagnose endometriosis are only done if symptoms become troublesome and are not eased by initial treatments (see below). This is because many women have endometriosis without symptoms, or with mild symptoms, and are never diagnosed. The exact number of women who develop endometriosis is not known. It is not intended to exclude or dismiss individuals who do not identify as female. For the purpose of this leaflet 'girls, females, or women' are those individuals assigned as female at birth.
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